Kanti Today

The role of Kanti Children's Hospital

Kanti Children's Hospital has an unique role to play in the development of paediatric medicine in Nepal. It provides health care for a large number of children in Nepal; from the newborn up to 14 years of age. It has a wide range of services to offer in both medicine and surgery with specialized neonatal, immunization, oncology, nutrition and other services as described above. This wide ranging activity offers an excellent basis for the Paediatric training of local medical students.

In addition, KCH increasingly acts as a focal point for visiting medical students from abroad. In particular, it acts as a valuable learning vehicle for those interested in tropical paediatric medicine. many cases are present which are seldom seen in the West.

Kanti Children's Hospital at present offers 300 beds. An increasing number of children are visiting the hospital for specialized treatment, for example to a neurosurgical OPD clinic staffed by a visiting doctor from the Teaching Hospital. Most come from poor or middle class families. They often travel great distances and their parents need somewhere to stay. With the help of donations from various organizations (including the Social Services National Coordination Council and Nepal German Help Association) a "patients' second home" has been set up with sleeping, cooking and washing facilities.

Special care is provided for particularly poor and needy patients through the help of Social Action Volunteers KCH Unit. Their auxiliaries offer help on a variety of levels from providing blood or medicine to feeding or transporting the patient home after treatment. They also run a playroom and provide accommodation for some parents free of charge. Immunisations (including BCG, Polio, DPT and Measles) are free of charge.

Staffing of KCH

The hospital is run by the development board and the director acts as the member secretary of the hospital board. At present around 500 staff are employed. Of these $53 are doctors (not including the Institute of Medicine staff) and $103 nursing, administrative and supporting staff. The Outpatient Department is open from 9am to 2pm Sunday to Friday. The Emergency Department and laboratory, the blood bank, the X-ray department, the telephone exchange, cash counter and pharmacy are open as 24 hour services.

There are two types of staffing patterns:

• Regular staff
• Hospital Board staff

Regular staff are appointed by the Ministry of Health. Hospital Board staff are employed on contracts, or paid daily wages on a temporary basis. Hospital accommodation is provided for up to $65 staff including doctors, nursing and others.

Financing of KCH

The hospital receives a lump sum budget from the HMGN. This is divided into two sectors:

• Regular budget. This covers HMGN staff salaries and allowances.
• Development budget. This is used to run the hospital It covers everything from building construction, to purchase of goods, laboratory and X-ray chemicals, electricity, water, telephone, disposable items, suture materials, dietary medicines charges, stationery and furniture provision.

Special trust funds

The Hashimoto Trust Fund has been setup following a generous donation gratefully received from the Rt. Hon. Prime Minister Mr. Ryutaro Hashimoto of Japan. The interest from this deposit is utilized to buy medicine for the poor and needy. Ms. Carmel Dersch (formerly Assistant Service Manager, Alder Hey Children's Hospital, Liverpool, UK) has supported the establishment of the KCH Oncology fund. Similarly the Nepal Paediatric Society offers support for a cancer fund for poor patients admitted to the ward. In addition, 50% of the fees from students doing their medical/nursing/pre-med electives go towards this fund.

Kanti Children's Hospital Appeal Fund has been set up with an initial donation from Dr. Anna Muthesius in England. This has established an emergency medicines cabinet that will provide free drugs for patients who cannot afford to purchase them.

Admission procedures

Three types of admission system are in operation:

• Emergency/Observation wards admission.
• Outpatient Department (OPD) referral admission.
• Follow up department admission.

Special emphasis on teaching

KCH is actively involved in the teaching programme of the attached Institute of Medicine (i.e. in the MBBS, MD Paediatrics, DCH, MS, Nursing and paramedics qualifications). National and international training programmes are conducted throughout KCH, including diarrhoea management, newborn care, integrated management of childhood illness (e.g. IMCI and ARI). The Nepal Paediatric Society (NEPAS) conducts regular monthly clinical meetings for doctors, nurses and paramedics, and these are attended by members of the Paediatric Department of the Institute of Medicine. Theoretical and clinical teaching is conducted at KCH and newly qualified doctors complete their paediatric internship here. The KCH Education Promotion Unit has been established recently.

Recently KCH has been providing places for NAMS (National Academy of Medical Science) students.